内镜下乳头括约肌切开术治疗胆总管结石63例分析

目的 探讨内镜下乳头括约肌切开术(EST)治疗胆总管结石的效果与价值. 方法对本院内镜治疗胆总管结石63例的临床资料进行总结分析. 结果 63例中,内镜乳头括约肌切开取石成功46例,内镜乳头括约肌球囊扩张4例,乳头旁瘘直接网篮取石3例,取净结石共53例,成功率为84.1%,10例因结石过大等原因改为择期剖腹手术或中转急诊手术.37例胆总管结石合并胆囊结石均于内镜取胆总管结石后再行腹腔镜胆囊切除术,全部成功.发生急性胰腺炎3例,急性胆管炎1例,结石嵌顿1例,活动性出血2例.63例均治愈,平均住院9d.随访所有病例均无胆总管残留结石存在.结论 内镜下乳头括约肌切开术治疗胆总管结石,安全、有效,患者痛苦小.

Endoscopic sphincterotomy in choledocholithiasis:report of 63 cases

Objective To investgate the efficiency and value of endoscopic sphincterotomy(EST)for choledocholithiasis.Methods Six-three patients with choledocholithiasis treated by endoscopic sphincterotomy were reviewed.Results Among 63 cases,the calculi were completely cleared in 53 cases,including EST in 46 cases,EPBD in 4 cases and parapapillary fistula in 3 cases.The clearance rate was 84.1%.The other 10 cases were changed to use surgical operation or emergency operation.There were 7 cases with complications included acute pancreatitis 3 cases,acute cholangitis 1 case,stone impacted at papillary 1 case,active hemorrhage 2 cases.All the patients were cured.Average hospitalization was 9d.All the follow-up cases had no residual choledocholithiasis.Conclusion Endoscopic sphincterotomy is safe,effective and painless for the patients with choledocholithiasis.